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NUTR 505 Public Health Nutrition > Midterm > Flashcards

Midterm Flashcards

1
Q

Public health is defined as…

A

the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society.

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2
Q

Activities to strengthen public health capacities and service aim to

A
  1. provide conditions under which people can maintain to be healthy
  2. improve their health and well-being
  3. pr prevent the deterioration of their health
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3
Q

Public health aims…

A
  • create conditions that create opportunities to be healthy (behaviours), policies, programs, laws
  • create conditions that prevent disease
  • create science and new knowledge to inform public health actions
  • evaluate impacts of policies and programs
  • engage communities
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4
Q

List 5 of 12 public health aspects that Quebec and Canada is concerned about

A
  1. Safer and healthier foods
  2. Control of infectious diseases
  3. Vaccination
  4. Healthier mothers and babies
  5. Safer workplaces
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5
Q

Public health agency in Canada empowers Canadians to improve their health. Its activities focus on…

A
  • preventing disease and injuries
  • promoting good physical and mental health
  • providing information to support informed decision making
  • values scientific excellence
  • provides national leadership in response to public health threats.
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6
Q

Le Programme National de Sante Public

A
  • defines PH services offered by the Department of Health and Social Services and its network.
  • it structures PH action to maintain and improve the health of the population through quality services, which are adapted to the specific needs and realities of all the territories of Quebec
  • services target people and their living environments, paying particular attention to the most vulnerable groups, thereby helping to reduce social inequalities in health.
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7
Q

Core functions of public health

A
  1. Health assessment
  2. Health surveillance
  3. Health promotion
  4. Injury and disease prevention
  5. Health protection
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8
Q

Health assessment

A

assessing factors that influence health
- to identify what influences (risks and contributing factors) health on a population. It then works to develop priorities and improve for policies programs and services for the public

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9
Q

Health surveillance

A

data systems
- using multiple sources and data systems at local, provincial, and national levels, it gathers, analyses and interprets information on the health of the population

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10
Q

Health promotion

A

empowering communities to take control of over the determinants of their health

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11
Q

What are the 5 health promotion actions?

A
  1. strengthening community action
  2. creating supportive environments
  3. developing personal skills
  4. building healthy public policy
  5. reorienting health services
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12
Q

Injury and disease prevention

A

many can prevented by applying well-known knowledge that is readily available about preventing disease - seatbelts, immunization, physical activity

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13
Q

What are the core competencies for PH in Canada?

A
  1. public health sciences
  2. assessment and analysis
  3. policy and program planning, implementation, and evaluation
  4. partnerships, collaboration, advocacy
  5. diversity
  6. communication
  7. leadership
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14
Q
  1. Public health sciences
A

Behavioural and social sciences, biostatistics, epidemiology, environmental public health, demography, workplace health, and the prevention of chronic diseases, infectious diseases, psychosocial problems and injuries.

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15
Q

Name 2 Canadian PH agencies

A
  • PH agency of Canada
  • Canadian Food Inspection Agency
  • Health Canada
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16
Q

Name 2 PH agencies in QC

A

INSP

Ministry of Health

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17
Q

Give 2 examples of Canadian PH laws

A

food label laws and acts

laws about substances and alcohol

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18
Q

Give 2 examples of QC PH laws

A

RAMQ

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19
Q

What are the current public health issues in Canada

A

chronic disease

youth and substance abuse

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20
Q

What are the current PH issues in QC

A

family doctors

english speaking

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21
Q

Identify 2 vulnerable population

A 
children and mothers
prisons 
transgenders
immigrants
indigenous
elderly
handicapped
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22
Q

John Snow and the Broadstreet Pump

A

John Snow’s study of its causes and his hypothesis that germ-contaminated water was the source of cholera, rather than particles in the air (referred to as “miasmata”). This discovery came to influence public health and the construction of improved sanitation facilities beginning in the mid-19th century.

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23
Q

Paradigm shift

A

a concept identified by the American physicist and philosopher Thomas Kuhn, is a fundamental change in the basic concepts and experimental practices of a scientific discipline.
ex: moving from miasma to germ theory

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24
Q

What are the 6 eras of PH

A
  1. health protection era
  2. miasma control era
  3. contagion control
  4. preventive medicine
  5. primary healthcare
  6. health promotion
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25
Q

Explain the health protection era

A
  • diseases may be prevented by enforced regulation of human behaviour, mediated through societies social structures
  • spiritual practices, quarantine
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26
Q

Explain miasma control era

A
  • addressing unsanitary environmental conditions may prevent diseases
  • drainage, sewage, refuse disposal
  • modern epidemiology and surveillance
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27
Q

Explain contagion control era

A
  • germ theory
  • water filtration, vaccination, outbreak measures
  • foundations of chemotherapy, vaccination
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28
Q

Explain preventive medicine era

A
  • special population
  • mosquitos
  • communicable and non-communicable diseases
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29
Q

Explain primary healthcare era

A
  • health for all: effective healthcare geared toward the community
  • equity and social determinants of health
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30
Q

Explain health promotion era

A

advocacy for health

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31
Q

Health promotion as a term was used for the first time by…

A

Marc Lalonde

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32
Q

What did Marc Lalonde suggest in terms of healthcare?

A

Healthcare services were not the most important determinants of health. Major improvements in health would result from improvements in lifestyle, environment and our knowledge of human biology

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33
Q

What are the 4 pillars of Lalonde’s health field concept

A

Health

  • human biology
  • environment
  • healthcare
  • lifestyle
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34
Q

Ottawa Charter for Health promotion

A

this conference was primarily a response to growing expectations for a new public health movement around the world.

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35
Q

What is health promotion?

A

is the process of enabling people to increase control over, and to improve their health.

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36
Q

Health promotion says: to reach a state of complete physical, mental, and social well-being, and individual or group must be…

A

able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment

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37
Q

What is health in terms of health promotion?

A
  • health is seen as a resource for everyday life, not the objective of living
  • is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life.
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38
Q

What are the new public health actions in terms of health promotion

A
  • build health public policy
  • create supportive environments
  • strengthen community action
  • develop personal skills
  • reorient health services
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39
Q

What are some rules of the Blue Zones?

A 
move naturally
wine five
right tribe
80% rule
loved ones first
40
Q

What are the social structures of health underlying patterns of inequalities?

A
  • social class
  • gender
  • racism
  • poverty
  • educational status
  • underlying power, status, and access to resources
41
Q

What does the population health promotion say?

A
  • to improve the health of the population ACTION must be taken on a full range of health determinants
  • examines interaction among a complex set of individual level and collective level determinants
  • applying a PHP lens helps us understand the multiple contexts the INFLUENCE of healthy eating
  • applying a PHP lens can hep identify the means to promote healthy eating through a wide variety of strategies that will affect entire populations
42
Q

What is the health promotion approach?

A
  • comprehensive action strategies are needed to influence the underlying factors and conditions that determine health
  • consistent with a socio-ecological model
43
Q

What are the determinants of health?

A
  • individual level (beliefs, gender, age, skills)
  • social environment (culture, social cohesion, income, equity)
  • built environment (transport, land-use patterns, urban design, green space)
  • natural environment (air, water, weather, topography)
44
Q

What is the conclusion of the Whitehall Study?

A
  • as hierarchy goes down, sickness increases due to stress
45
Q

What are the factors that affect our choices?

A 
price
appearance, smell
time
convenience
information/media
state of mind
habit 
expectation
social situation
46
Q

What is nudge theory?

A

any aspect of choice architecture that alters people’s behaviour in predictable ways without restricting any options or significantly changing their economic incentives such as time or money

47
Q

Explain libertarian paternalism

A

Libertarian

  • freedom of choice should never be in doubt
  • architects should preserve or increment number of choices

Paternalism
- architects can influence behaviours to make people’s lives better as judged by people themselves

48
Q

Nudge vs Shove

A
  • in nudge we are trying to change the pathway and make things easier and help us make choice healthier option
  • shove would be an example of putting tax on sugared beverages.
49
Q

Decision making (automatic vs reflective)

A

automatic: hot state
reflective: cold state

50
Q

Nudges to help improve choices:

A
  • iNcentives
  • Understand “mappings”
  • Defaults
  • Give feedback
  • Expect error
  • Structure complex choices
51
Q

Explain the population strategy of prevention

A
  • is needed when risk is spread out in the population
  • those in population having small risk for disease would be considered normal in the high risk prevention strategy
  • we need to consider the impact on health of a large proportion of people at low risk
52
Q

What are the 4 scenarios of risk related to exposure and give examples

A
  1. exposure is without adverse effects until it reaches a certain high level after which risk increases rapidly (intra-ocular pressure, anemia)
  2. a linear dose relationship over the whole range of exposure. Any level is regarded as harmful, with increasing adverse effects being in proportion to the dose. (cigarette smoke and lung cancer)
  3. increasing risk with advancing exposure (osteoporosis-fracture)
  4. deviant or extremes with a stable band in the middle (weight and mortality)
53
Q

Explain the bell-curve shift in populations

A

shifting the whole population into a lower risk category benefits more individuals than shifting high risk individuals into a lower risk category

54
Q

Value of theory in health interventions

A
  • accumulating evidence suggest that interventions developed with an explicit theory are more effective than without a theoretical base
  • some strategies that combine multiple theories and concepts have larger effects
55
Q

What are the steps of the socioecological model?

A
  • individual: knowledge, attitudes, skills
  • interpersonal: family, friends, social networks
  • organizational: organizations, schools, workplaces
  • community: design, access, connectedness, spaces
  • public policy: national, provincial/territorial local laws and policy
56
Q

Why use health behaviour theories?

A
  • theories and models help explain behaviour
  • guid how to develop more effective ways to influence and change behaviours
  • tools to facilitate our practice of planning and evaluating health interventions
  • theory is a representation of how we think the world works
  • health behaviour theory can contribute to program planning and evaluation and to advance research to test innovative intervention strategies
57
Q

Behavioural health theories are…

A

a set of interrelated concepts, definitions, and propositions that present systemic view of situations by specifying relations among variables, in order to explain and predict the situations

58
Q

What are the most applied theories in health behaviour research?

A
  • The Health Belief Model (HBM)
  • The Trans-theoretical Model/Stages of Change (TTM)
  • Social Cognitive Theory (SCT)
  • The Social Ecological Model (SEM)
59
Q

What is the Health Belief Model (HBM)?

A

HBM theorizes that people’s beliefs about whether they are at risk for a disease or health problem, and their perceptions of the benefits of taking action to avoid it, influences their readiness to take action.

60
Q

What are the person characteristics in the HBM that affect perception?

A

Personal characteristics, such as age, gender, and ethnicity modify individual perceptions, such as perceived susceptibility, severity, self-efficacy, and benefits & barriers

61
Q

What is perceived threat?

A

Perceived susceptibility and severity of a health condition together

62
Q

______ help reduce perceived threat about a health behaviour. ______ impede health behaviours.

A

perceived benefits

perceived barriers

63
Q

What is self-efficacy and how does it play a role in HBM?

A

Self-efficacy influences perceived threat (perceived susceptibility and severity) and perceived benefits minus perceived barriers, which support initiation of health behaviour change.

64
Q

What are the 6 constructs of HBM?

A 
Perceived susceptibility 
Perceived Severity 
Perceived Benefits
Perceived Barriers
Cues to Action
Self-Efficacy
65
Q

What is perceived susceptibility? Give an example.

A

belief about getting disease or condition

ex. chances of getting breast cancer are high.

66
Q

What is perceived severity? Give an example.

A

belief about the seriousness of the condition, or leaving it untreated and its consequences
ex. my marriage would be endangered if I had breast cancer

67
Q

What is perceived benefits? Give an example.

A

belief about the potential positive aspects of a health action
ex. getting a mammogram is a routine part of my check-ups

68
Q

What is perceived barriers? Give an example.

A

belief about the potential negative aspects of a particular health action
ex. getting a mammogram is too embarrassing

69
Q

What are cues to action? Give an example

A

factors which trigger action

ex. hearing about breast cancer in the news makes me think about getting a mammogram

70
Q

What is self-efficacy? Give an example. How to use it?

A

belief that one can achieve the behaviour required to execute the outcome. or belief in ones’s ability to perform a given behaviour. It is task specific, meaning that self-efficacy can increase or decrease based on the specific task at hand, even in related areas.

ex. how sure are you that you know how to arrange and appointment for a mammogram?

How to use it: Break down behaviour change into small, measurable steps. Allow intervention participants to recognize and celebrate small successes along the path to larger behaviour change.

71
Q

What is the social cognitive theory? (SCT)

A
  • based on Albert Bandura’s work
  • he demonstrated that violent behaviours that were modelled by adults on a Bobo Doll were imitated by children. This effect was repeated when children observed the same behaviour on TV
  • is an interpersonal level theory developed by Albert Bandura that emphasizes the dynamic interaction between people (personal factors), their behaviour, and their environments
72
Q

What are the key constructs of SCT?

A
  • observational learning
  • reinforcement
  • self-control
  • self-efficacy
73
Q

SCT is an interpersonal level theory developed by Albert Bandura that emphasizes the dynamic interaction between people (personal factors), their behaviour, and their environments. This interaction is demonstrated by…..

A

the construct called Reciprocal Determinism. Personal factors, environmental factors, and behaviour continuously interact through influencing and being influenced by each other.

74
Q

What is self-control/regulation? How to use it?

A

Controlling oneself through self-monitoring, goal-setting, feedback, self-reward, self-instruction, and enlistment of social support.

How to use it: Build in goal-setting activities throughout the intervention. Work with participants to create realistic and measurable goals. Allow time for reflection and evaluation about success or failure in meeting goals.

75
Q

What is observational learning? How to use it?

A

beliefs based on observing similar individuals or role models perform a new behaviour.

How to use it: Provide credible role models who reflect the target population and perform the desired behaviour.

76
Q

What is reinforcement?

A

This refers to the internal or external responses to a person’s behaviour. Reinforcements can be self-initiated or in the environment, and reinforcements can be positive or negative. This is the construct of the SCT that most closely ties to the reciprocal relationship between behaviour and environment

77
Q

What is the construct of the SCT that most closely ties to the reciprocal relationship between behaviour and environment?

A

reinforcement

78
Q

What is the thranstheoretical model (TTM) or stages of change theory?

A

is best thought of as a cyclical and recycling process where individuals process in order of stage but can relapse and recycle through stages several times; they may or may not ever reach the last stage.

79
Q

What are the 5 stages of change?

A
  • precontemplation
  • contemplation
  • preparation
  • action
  • maintenance
80
Q

What is precontemplation?

A

unawareness or denial of problem. No intention to change behaviour in the next 6 months

81
Q

What is contemplation?

A

considering behaviour change, with no preparation, in the next 6 months but not within next 30 days

82
Q

What is preparation?

A

taking initial steps to change behaviour in the next 30 days

83
Q

What is action?

A

actively engaged in behaviour change in the next 30 days but not 6 months

84
Q

What is maintenance?

A

sustaining behaviour change that occurred in the last 6 months

85
Q

What are the 2 processes of change?

A
  • cognitive - affective (experiential) process

- behavioural processes

86
Q

Explain the 5 aspects of cognitive - affective (experiential) process

A
  1. consciousness-raising (gathering information)
  2. self-evaluation (reconsidering consequences on oneself)
  3. dramatic relief (experiencing and expressing affect
  4. environmental evaluation (considering consequences on others)
  5. social liberation (attending to changing social norms)
87
Q

Explain the 5 aspects of behavioural process

A
  1. counterconditioning - substituting new behaviour
  2. stimulus control - controlling environmental cues
  3. reinforcement management - being rewarded by self or others
  4. helping relationships - using social support
  5. self-liberation - committing to change
88
Q

What is the socioecological model?

A
  • there are many levels of influence (individual, interpersonal, organizational, community, and public policy)
  • behaviours shape and are shaped by the social environment
89
Q

Surveillance aims to

A

help making informed decisions in the health and social services sector as well as in other sectors of activity that affect health, by addressing the need for further information on the health status and its determinants, as well as by informing the population about its health status.

90
Q

Surveillance includes:

A
  • an overall picture of the health status of the population
  • the observation of temporal and spatial trends and variations
  • the detection of emerging problems
  • the recognition of priority problems
  • the development of projection scenarios with regard to the health status of the population.
  • followup of the evolution, within the population, of specific health problems and their determinants
  • the dissemination of information to decision makers
91
Q

Surveillance also allows for:

A
  • ongoing support to promotion, prevention and protection through data acquisition, and production, analysis and dissemination of relevant and updated information on the health status and its determinants
  • support for the planning and organization of health and social services, in a population-based approach
92
Q

public health nutrition surveillance consists of…

A

monitoring and anticipating health events and the determinants of health related to nutrition and food

93
Q

public health nutrition surveillance data includes…

A
  • food consumption and nutrient intakes
  • food safety and exposure to environment-related risks
  • nutritional status
  • effects of nutrition on health
  • knowledge, attitudes, and behaviours relative to healthy eating habits as well as other lifestyle habits
  • demographic factors
  • determinants of health related to individuals and the environment
  • factors that have an impact on access to nutritious, safe, and affordable foods
94
Q

What are the key surveillance sources in Canada?

A
  • Statistics Canada
  • CCHS (Canadian Community Health Survey)
  • CHMS (Canadian Health Measures Survey)
  • INSPQ
  • NRBHSS
  • FNIGC
95
Q

Which age group is the most overweight and obese in Quebec?

A

50-64

96
Q

Where in Quebec has the most overweight and obese?

A

Montreal

NUTR 505 Public Health Nutrition (3 decks)

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